HomeMy WebLinkAbout1707 Brentford Ln - Permits/Gas - Log, Line, Pipe - 02/04/1988City of Fort Collins BUILDING INSPECTION DIVISION
APPLICATION FOR BUILDING PERMIT AND CERTIFICATE OF OCCUPANCY
Applicant complete this part of form only.
Press firmly using ball point pen.
Job Address 70 2:>2T--KtTF:OP
Name ��d )•- Q. Ge
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Address C• Cc, I I i S c_I
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License No.
Phone
Contractor Sales Tax No. /D 4
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Lot
Block
Filing Number
Subdivision
PUD
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Parcel #
DESCRIPTION OF WORK
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' ft
Stock Options
Plan No. Codes
ESL Total CosA S O O O
(including labor, material, profit)
I hereby acknowledge that I have read this application and
state that the above is correct and agree to comply with all city
ordinances and state laws regulating building construction.
signed date
— CLASS OF WORK —
New Alteration Addition Demolish Move
❑ ❑ ❑ ❑ ❑
Plbg. Mech. Elec. Struct. Fire Prot.
❑ ❑ ❑ ❑ . ❑
Occ. Gr. Type Const.
Use Zone
Use of Building
Floor Area
HeigLFrontage
No. Stories
Lot Area
Occ. load
Occ. Change fromPlat
File No.
No. D.U.Garage
area
Fin. BsmtType
heat
No. Firepl
— RELEASES — Dates
Zoning
Engineering
Fire Department
Electric Department
Water B Sewer
Plan Review r
Special Conditions:
Valuation FEES
Plan Check
Permit
IS -O
Parkland
City Sales Tax
t-g:-7. 0410
St. Oversizing
Water Plant Investment
Sewer Plant Investment
Storm Drainage
Electric Underground
Total Fees
Off -Street Parking
(No. Cars)
Interior Lot ❑
Corner Lot ❑
Reversed Corner Lot ❑
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TOTL 15.00
Street 11421846 13:07 A
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ZBA Case It Date
BBA Case # Date
Building Insp. Approval
by date
Permit No.
Date
.00
Distribution: original - Applicant: Blue - Office: Canary - Sales Ta.:.Pink - Applicant: Tag - Bldg. Inap, _